TORP Ossiculoplasty Outcomes with and without a Stapes Footplate Prosthesis

Abstract

The titanium stapes footplate prosthesis (FPP) was designed to ensure a stable connection of a total ossicular replacement prosthesis (TORP) to the stapes footplate and maximize acoustic coupling by centering the footplate on the oval window. Our goal was to assess the impact of the FPP on TORP ossiculoplasty outcomes. Case series with chart review. Tertiary care center. Adult patients undergoing TORP ossiculoplasty with (n=53) or without (n=108) a stapes FPP. Rate of prosthesis displacement and audiologic outcomes were tabulated for statistical analysis. A lower rate of prosthesis displacement and statistically better audiologic outcomes were seen in FPP patients. The pure-tone average air-bone gap (PTA-ABG) was closed to <20 dB in 69.8% (37/53) of patients in the study arm and 44.4% (48/108) of patients in the control arm (P=.003). The PTA-ABG was decreased by a mean±SD of 19.3±11.7 dB and 12.6±11.0 dB in the study and control groups, respectively (P=.0012). Use of the titanium stapes FPP during TORP ossiculoplasty provides a statistically significant advantage in short-term PTA-ABG closure and a higher rate of successful rehabilitation of conductive hearing loss. Further studies are necessary to assess any long-term advantages a FPP may offer.